Inpatient hospice funding is a national crisis, says Brian's House medical director

View full sizeBay City Times fileDr. Michael Parmer is seen in a 2007 file photo.

BANGOR TOWNSHIP, MI — The closing of Brian’s House is not just a local issue, said Dr. Michael Parmer, medical director for Brian’s House and vice president of medical affairs for McClaren’s Homecare Group.

“This is happening in virtually every community in Michigan and nationally as well,” Parmer said. “The hospice in Mount Pleasant is losing huge amounts of money and there are two in northern Michigan where finances are as bad or worse (than at Brian’s House). It’s becoming a crisis.”

Parmer has worked at Brian’s House for 16 years and watched it change from a hospice house to a certified inpatient hospice facility. He said his office is located at the Davison Brian's House facility, but most of his daily work is in Bay County.

The Davison location, which has 12 beds, will also close Sept. 4.

Brian’s House began as a community-run program in a six-bedroom house on Hamilton Road between Knight and Jones roads in Essexville and was partially sponsored by the Bay Medical Foundation.

“We were small and able to provide a very limited amount of care in comparison (to the current Brian’s House facility),” Parmer said.

In the late 1990s, the federal government increased funding for end-of-life care like hospice. Because of this increased funding, Brian’s House decided to become a certified inpatient hospice facility.

“We went through the certification process for inpatient qualification and passed with flying colors,” he said. “I remember the survey said we had a wonderful facility and we were doing everything we were supposed to do.”

Parmer said the government’s emphasis on end-of-life care changed. The Centers for Medicare and Medicaid Services tightened the criteria to cover end-of-life care at inpatient facilities and it became more difficult for patients to qualify for reimbursement at facilities like Brian’s House.

“That’s when the national turn happened,” he said. “We have a unit here with 19 beds and we basically average four to six people at any time. Of those, only one or two have full inpatient level of care.”

The decrease in patients has made the facility financially unsustainable.

“We have struggled for months with how to make this work,” Parmer said. “We have looked for other (inpatient hospice) programs in the state and nationally who have figured it out, but nobody has an answer.”

Parmer said Brian’s House filled a niche in end-of-life care and will be missed in the community.

“This is a great option for certain patients and their families,” he said. “There were some things offered (by Brian’s House) that home care can’t (offer), like the ability to be with your loved one and just be family, not caregivers.”

“We’re going to have to figure out another way to provide the care people need and I’m determined that we will,” Parmer said.

Many in the community are upset by the closing, and Parmer understands.

“I understand the anger. I have a little myself,” Parmer said. “The only thing I can tell you is that this is an incredibly sad event for all of us.”

“I have heard a lot of frustration and people saying it’s just about money and ultimately, I have to say, 'They’re right.'”

Parmer said he understands why people want to blame McLaren Bay Region for the closing because “it’s easy. It’s a nebulous body that doesn’t have a face.”

However, Parmer said this is a problem affecting hospice programs across the country.

Closing Brian's House will be especially difficult for the facility's 50 employees.

McLaren Bay Region will work to find other jobs within the company for as many as possible, McLaren said in a news release Tuesday.

“This is a very difficult time for all of them,” Parmer said. “We want to keep as many in the system as we can because they are quality, good people. I have been blessed to be associated with each and every one of them.”

It takes a certain type of person to do the emotionally-taxing work of caring for people at the end of their lives, he said.

“It’s almost a calling,” he said. “There are people that want to (work with hospice) and find that emotionally they can’t handle it. Those that have truly got the passion are committed.”